Tatour Mifleh, Zuckerman Eli, Abu-Freha Naim, Hazzan Rawi
Clalit Health Services, Northern Region, Tel Aviv, Israel.
Department of Family Medicine, Clalit Health Services, Afula, Israel.
Sci Rep. 2025 Apr 16;15(1):13212. doi: 10.1038/s41598-025-96342-7.
Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease that can lead to cirrhosis in up to 30% of patients. Cirrhotic patients are at risk of high morbidity and mortality due to cirrhosis decompensation and hepatocellular carcinoma (HCC). This retrospective study assessed the rates of decompensated cirrhosis and HCC in patients with AIH-related cirrhosis. A total of 774 AIH patients were included, with 40% developing cirrhosis. Over a median follow-up of 8.2 years (IQR 2.9-12.3), the annual incidence of decompensated cirrhosis was 4.25%, with a mean time of 8.2 years from cirrhosis diagnosis to decompensation. Nineteen cirrhotic patients (6.2%) developed HCC, with a yearly incidence rate of 0.63%. Most HCC cases occurred within the first years of cirrhosis diagnosis. The rate of decompensated cirrhosis in AIH patients was lower than in other cirrhotic liver diseases, suggesting AIH may follow a different clinical course. The annual incidence of HCC was also significantly lower than the threshold for HCC surveillance. This indicates the need to reassess current surveillance guidelines, particularly in the late years following a cirrhosis diagnosis.
自身免疫性肝炎（AIH）是一种慢性炎症性肝病，高达30%的患者可发展为肝硬化。肝硬化患者因肝硬化失代偿和肝细胞癌（HCC）而面临高发病率和死亡率的风险。这项回顾性研究评估了AIH相关性肝硬化患者的失代偿性肝硬化和HCC发生率。共纳入774例AIH患者，其中40%发展为肝硬化。在中位随访8.2年（四分位间距2.9 - 12.3年）期间，失代偿性肝硬化的年发病率为4.25%，从肝硬化诊断到失代偿的平均时间为8.2年。19例肝硬化患者（6.2%）发生了HCC，年发病率为0.63%。大多数HCC病例发生在肝硬化诊断后的头几年。AIH患者的失代偿性肝硬化发生率低于其他肝硬化性肝病，提示AIH可能遵循不同的临床病程。HCC的年发病率也显著低于HCC监测阈值。这表明有必要重新评估当前的监测指南，尤其是在肝硬化诊断后的后期。
